Prevalence and Risk Factors of Adverse Drug Reactions Associated Multidrug Resistant Tuberculosis Treatments in Selected Treatment Centers in Addis Ababa Ethiopia

Introduction: The key to successful elimination of tuberculosis (TB) is treatment of cases with optimum chemotherapy. Irrational anti-TB drug use over time has led to drug-resistant TB. The treatment of MDR-TB with second line drugs is long, complex and costly, and has a considerable rate of adverse effects. The level of ADR reporting is low in Ethiopia due to different factors. This Study conducted in a selected treated area in Addis Ababa, Ethiopia and helped the health care centers to understand the prevalence of ADR related MDR-TB and be aware of those adverse effects in order to detect them early and be prepared to take proper steps when they occur. Aim of the Study: To determine the prevalence and risk factor of adverse drug reactions associated treatments of Multidrug Resistant tuberculosis. Method: This was a cross sectional study, which was conducted between March 2012 and February 2013 at St. Peter TB specialized hospital and AHRI/ALERT. 73 MDR TB patients, who were on MDR TB treatments, enrolled to the study. Adverse Drug Reactions associated MDR TB treatments were assessed by patient history review and questionnaire. Chemistry laboratory was used to test renal function, thyroid function, liver enzyme and potassium level. Result: In 72 patients, at least two ADRs were found. The mean age of the study population (Mean ± SD) was 28 ± 8.8. In this study the most commonly found adverse drug reactions (ADRs) were: Anorexia 83.3%, Nausea and vomiting 82%, Gastritis 64%, Arteralgia 47%, Skin rash and itching 45%, Headache 29.2%, Depression 22.2% and Blurred vision 19.4%. Using binary logistic regression model older age (COR 8.71, 95% [CI] 1.06 - 71.9), alcoholism (COR 4.05, 95% [CI] 1.05 - 15.6), smoking (COR 0.24, 95% [CI] 0.06 - 0.87) and concomitant drug intake (COR 0.14, 95% [CI] 0.03 - 0.76) were independent predictors for ADRs. Conclusion: The prevalence of ADRs related MDR TB treatments is high. To minimize ADR occurrence, ADR predictors should be integrated into the clinical pathway. Monitoring of liver function, renal function, TSH and level of potassium during MDR TB treatment, helps to avoid complication caused by therapy and increase the adherence to the treatment.

Haptoglobin polymorphism, plasma haptoglobin level and ABO blood group in leprosy patients

Objective: To analyze haptoglobin polymorphism, plasma haptoglobin concentration, and ABO blood groups associated with leprosy. Methods: Blood groups were determined using monoclonal anti-A and anti-B. Haptoglobin was genotyped by PCR;plasma haptoglobin concentration was measured by ELISA. Data were analyzed by SPSS version 21 and P-values ≤ 0.05 were considered as statistically significant. Results: ABO blood groups in leprosy patients were found to have no significant difference compared to controls and the general population (P > 0.05). The data showed a lower frequency of Hp1-1 (14.6%) and higher frequency of Hp2-2 (25.6%) in leprosy patients compared to healthy controls (23.1% and 19.8%, respectively), without significant association (P = 0.315). The mean of haptoglobin concentration was higher in leprosy patients [(1.32 ± 0.70) mg/mL] than in healthy controls [(1.17 ± 0.67) mg/mL] (P = 0.160). The mean (1.44 mg/mL) and median (1.37 mg/mL) values of haptoglobin concentration were significantly higher in male leprosy patients than in male healthy controls (1.11 mg/mL and 1.11 mg/mL, respectively) (P= 0.018). Independent sample t-test and One-way ANOVA analysis also indicated significant mean elevation of Hp along leprosy spectrum and bacterial index (P < 0.05). Conclusions: In conclusion, the study revealed absence of influence of Hp polymorphism and ABO blood groups on leprosy occurrence;however, plasma haptoglobin concentration elevates in leprosy patients and is significantly associated with leprosy spectrum and bacterial loads in patients.